Medicine:Human givens

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This is about psychotherapy. See Human condition for the general topic.

Human Givens is the name of a theory in psychotherapy formulated in the United Kingdom , first outlined by Joe Griffin and Ivan Tyrrell in the late 1990s.[1] and amplified in the 2003 book Human Givens: A new approach to emotional health and clear thinking.[2] The human givens organising ideas[3] proffer a description of the nature of human beings, the 'givens' of human genetic heritage and what humans need in order to be happy and healthy. Human Givens therapy seeks to use a "client's strengths to enable them to get emotional needs met". It is advertised as "drawing from the best of person-centred counselling, motivational interviewing, cognitive behavioural therapy, psychoeducational approaches, interpersonal therapy, imaginal exposure and hypnotherapy". The Human Givens Institute has been accredited in the UK by the Professional Standards Authority for Health and Social Care (PSA).[4]

Historical background

Abraham Maslow is credited with the first prominent theory which laid out a hierarchy of needs.[5] The precise nature of the hierarchy and the needs have subsequently been refined by modern neuroscientific and psychological research.

Since Maslow's work in the middle of the twentieth century, a significant body of research has been undertaken to clarify what human beings need to be happy and healthy. The UK has contributed significantly to the international effort, through the ground breaking Whitehall Study led by Sir Michael Marmot, which tracked the lifestyles and outcomes for large groups of British civil servants. This identified effects on mental and physical health from emotional needs being met - for instance, it showed that those with less autonomy and control over their lives, or less social support, have worse health outcomes.

In the United States, the work of Martin Seligman, a psychologist at the University of Pennsylvania has been influential. Seligman has summarised the research to date in terms of what makes humans happy; again, this demonstrates themes about universal emotional needs which must be met for people to lead fulfilling lives.[6][7]

At the University of Rochester, contemporaries of Seligman Edward Deci and Richard Ryan have conducted original research and gathered existing evidence to develop a framework of human needs which they call self-determination theory. This states that human beings are born with innate motivations, developed from our evolutionary past. They gather these motivational forces into three groups - autonomy, competence and relatedness. The human givens approach uses a framework of nine needs, which map onto these three groups.

Innate needs

The human givens model proposes that human beings come into the world with a given set of innate needs, together with innate resources to support them to get those needs met. Physical needs for nutritious food, clean water, air and sleep are obvious, and well understood, because when they are not met people die. However, the emotional needs, which the human givens approach seeks to bring to wider attention, are less obvious, and less well understood, but just as important to human health. Decades of social and health psychology research now support this.[8]

The human givens approach defines nine emotional needs:

  1. Security: A sense of safety and security; safe territory; an environment in which people can live without experiencing excessive fear so that they can develop healthily.[9]
  2. Autonomy and control: A sense of autonomy and control over what happens around and to us.[10][11]
  3. Status: A sense of status - being accepted and valued in the various social groups we belong to.
  4. Privacy: Time and space enough to reflect on and consolidate our experiences.
  5. Attention: Receiving attention from others, but also giving it; a form of essential nutrition that fuels the development of each individual, family and culture.[12][13][14]
  6. Connection to the wider community: Interaction with a larger group of people and a sense of being part of the group.
  7. Intimacy: Emotional connection to other people - friendship, love, intimacy, fun.
  8. Competence and achievement: A sense of our own competence and achievements, that we have what it takes to meet life's demands.
  9. Meaning and purpose: Being stretched, aiming for meaningful goals, having a sense of a higher calling or serving others creates meaning and purpose.

These needs map more or less well to tendencies and motivations described by other psychological evidence, especially that compiled by Deci and Ryan at the University of Rochester.[15][16] The exact categorisation of these needs, however, is not considered important. Needs can be interlinked and have fuzzy boundaries, as Maslow noted.[17] What matters is a broad understanding of the scope and nature of human emotional needs and why they are so important to our physical and mental health. Humans are a physically vulnerable species that have enjoyed amazing evolutionary success due in large part to their ability to form relationships and communities. Getting the right social and emotional input from others was, in our evolutionary past, literally a matter of life or death. Thus, Human Givens theory states, people are genetically programmed only to be happy and healthy when these needs are met.

There is evidence that these needs are consistent across cultures, and therefore represent innate human requirements.[18][19][20]

Innate resources

The Human Givens model also consists of a set of 'resources' (abilities and capabilities) that all human beings are born with, which are used to get the innate needs met. These constitute what is termed an 'inner guidance system'. Learning how to use these resources well is seen as being key to achieving, and sustaining, robust bio-psycho-social health as individuals and as groups (families, communities, societies, cultures etc.).

The given resources include:

  • Memory: The ability to develop complex long-term memory, which enables people to add to their innate (instinctive) knowledge and learn;
  • Rapport: The ability to build rapport, empathise and connect with others;
  • Imagination: Which enables people to focus attention away from the emotions and problem solve more creatively and objectively (a 'reality simulator');
  • Instincts and emotions: A set of basic responses and 'propulsion' for behaviours;
  • A rational mind: A conscious, rational mind that can check out emotions, question, analyse and plan;
  • A metaphorical mind: The ability to 'know', to understand the world unconsciously through metaphorical pattern matching ('this thing is like that thing');
  • An observing self: That part of us which can step back, be more objective and recognise itself as a unique centre of awareness apart from intellect, emotion and conditioning;[21][22]
  • A dreaming brain: According to the expectation fulfilment theory of dreaming, this preserves the integrity of our genetic inheritance every night by metaphorically defusing emotionally arousing expectations not acted out during the previous day.

Three reasons for mental illness

A further organising idea[3] proffered by the human givens approach is to suggest that there are three main reasons why individuals may not be getting their needs met and thus why they may become mentally ill:

  1. Environment: something in our environment is interfering with our ability to get our needs met. Our environment is 'toxic' (e.g. a bullying boss, antisocial neighbours) or simply lacks what we need (e.g. community);
  2. Damage: something is wrong with our 'resources' -- our 'hardware' (brain/body) or 'software' (missing or incomplete instincts and/or unhelpful conditioning such as posttraumatic stress disorder) is damaged;
  3. Knowledge: we may not know what we need; or we may not have been taught, or may have failed to learn, the coping skills necessary for getting our needs met (for example, how to use the imagination for problem solving rather than worrying, or how to make and sustain friendships).

When dealing with mental illness or distress this framework provides a checklist that guides both diagnosis and treatment.

Key features

Key features of the human givens school include:

  • A new model of therapeutic intervention (the APET model) based on the neurological finding that emotion precedes thought.[23][24]
  • New insights into trauma and how to treat it effectively - the 'rewind technique'. (The human givens rewind technique has been evaluated in an international textbook on trauma.[25])
  • An holistic understanding of the evolutionary origins and function of human dreaming (expectation fulfilment theory of dreaming) which is key to understanding the cycle of depression: how depression develops, is maintained and can be successfully treated.[26]
  • A neuroscience-based explanation for addiction and why withdrawal symptoms occur;[27]
  • A theory (called 'molar memories') which explains the mechanism that generates and maintains some instances of compulsive behaviour (such as sexual compulsions, anorexia and bulimia);
  • A psychobiological explanation of clinical hypnosis, why it works and the mechanisms common to all forms of hypnotic induction;[28]
  • New understandings of the autistic spectrum disorder, including what has been termed ‘caetextia’;[29]
  • New insights into the nature of psychosis (waking reality processed through the REM state/dreaming brain);[30]
  • A clear protocol for conducting therapy sessions - the RIGAAR model: Rapport building; Information gathering; Goal setting (new, positive expectations related to the fulfillment of innate needs); Accessing the client's own strengths and resources (success templates); Agreeing a strategy (for achieving the needs-related goals); Rehearsing success (the enactment of the agreed strategies).

Research and evidence

There are now a number of independent studies evaluating the human givens approach:

  • Human givens randomised controlled trial: There are no randomised-controlled trials (RCTs) to test the human givens approach. The first RCT is in process; The Bristol Randomised Controlled Trial Collaboration (a partnership between the University of Bristol and the National Health Service) has agreed to help design it.
  • A 12–month evaluation of the human givens approach in primary care (2011): Peer reviewed evidence for the effectiveness of human givens therapy, published in Psychology and Psychotherapy: Theory, Research and Practice, showed that, of 120 patients treated by HG therapists in a GP's surgery, more than three-quarters were either symptom-free or reliably improved as a result of the therapy. This was accomplished in an average of only 3.6 sessions.[31] This compares favourably with the recovery rate for the UK Government’s Improving Access to Psychological Therapies (IAPT) programme, which mainly uses therapists trained in cognitive-behavioural therapy (CBT) and expects therapy to take longer; less than half of its patients improve or recover.
  • Using human givens therapy to support the wellbeing of adolescents (2011): An article for Pastoral Care in Education: An International Journal of Personal, Social and Emotional Development assessed the efficacy of an individual human givens intervention for three young people who reported high anxiety or depression and/or low self-concept. It found positive outcomes for the subjects which provided tentative evidence that human givens therapy might be useful to practitioners delivering therapeutic interventions in schools.[32]
  • Assessing the effectiveness of the “human givens” approach in treating depression (2012): A peer-reviewed research paper, published in Mental Health Review Journal found that treating people with mild to moderate depressed mood (measured using HADS) with human givens therapy had quicker results than the treatment provided to people in a control group.[33]
  • The Emotional Needs Audit: a report on its reliability and validity (2012): A peer-reviewed research paper published in the Mental Health Review Journal found that the Human Givens Institute’s Emotional Needs Audit (ENA) was a valid and reliable instrument for measuring wellbeing, quality of life and emotional distress. It also concluded that the ENA allows insight into the causes of symptoms, dissatisfaction and distress, complementing standardised tools when used in clinical practice.[34]
  • A 5–year evaluation of the human givens therapy using a Practice Research Network (2012): A peer-reviewed research paper published in the Mental Health Review Journal (2012) evaluated five year’s worth of practice-based evidence[35] gleaned from a practice research network. The pre-post treatment effect size suggested that “clients treated using the HG approach experienced relief from psychological distress”.[36]
  • Evaluation of human givens ‘rewind’ treatment to treat trauma (2013): A poster presentation for a veteran lead research conference evaluated the effectiveness of a single human givens rewind treatment session to treat PTSD in the general psychiatric population and found that this treatment can be effective with severe, chronic and even multiple traumas in a single session, with some requiring no further treatment.[37]

Organisations

The following constitute the main human givens organisations:

Human Givens Institute

The Human Givens Institute is a membership organisation open to those wishing to support and promote the human givens approach through all forms of psychological, educational and social interactions, and the professional body representing the interests of those in the caring and teaching professions who aim to work in alignment with the best scientific knowledge available about the givens of human nature. The Institute is accredited by the Professional Standards Authority for Health and Social Care.</ref>[4] for the purposes of regulating practitioners who have completed training as Human Givens Therapists and who are Registered with the Institute.

Human Givens Foundation

The Human Givens Foundation is a charitable organisation devoted to spreading the human givens philosophy and information into organisations concerned with health, education, business, social work and the wider care system, the police, the armed forces, and, more widely, into social policy and government. It aims to support parents, families, couples and individuals to live more harmonious, satisfying and meaningful lives.

Human Givens College

Human Givens College is a training organisation offering psychotherapy courses as well as a full psychotherapy diploma course leading to qualification as a human givens practitioner. There are currently 226 Registered Members on the HGI Register – people who have achieved part 3 of the diploma course and are set up in private practice.

See also

  • Ivan Tyrrell
  • Joe Griffin

Bibliography of publications

  • Griffin, J. & Tyrrell, I. (2013). Human Givens: The New Approach to Emotional Health and Clear Thinking. Human Givens Publishing. ISBN:1-899398-31-7
  • Griffin, J. & Tyrrell, I. (2004). How to lift depression fast. Human Givens Publishing. ISBN:1-899398-41-4
  • Griffin, J. & Tyrrell, I. (2007). How to master anxiety: Stress, panic attacks, phobias, psychological trauma and more. Human Givens Publishing. ISBN:1-899398-81-3
  • Griffin, J. & Tyrrell, I. (2004). Dreaming Reality: How dreaming keeps us sane, or can drive us mad. Human Givens Publishing. ISBN:1-899398-36-8
  • Griffin, J. & Tyrrell, I. (2013). Why We Dream: The Definitive Answer. Human Givens Publishing. ISBN:978-1899398423.
  • Griffin, J. & Tyrrell, I. (2005). Freedom from addiction: The secret behind successful addiction busting. Human Givens Publishing. ISBN:1-899398-46-5
  • Griffin, J. & Tyrrell, I. (2008). Release from anger: Practical help for controlling unreasonable rage. Human Givens Publishing. ISBN:978-1-899398-07-2
  • Griffin, J. & Tyrrell, I. (2007). An Idea in Practice: using the human givens approach. Human Givens Publishing. ISBN:978-1-899398-96-6.
  • Brown, G. & Winn, D. (2009) How to liberate yourself from pain. Human Givens Publishing. ISBN:978-1-899398-17-1

References

  1. ↑ Griffin, Joe; Tyrrell, Ivan (1998). Psychotherapy, Counselling and the Human Givens (Organising Idea). ISBN 978-1899398959. 
  2. ↑ Griffin, Joe; Tyrrell, Ivan (2003). Human givens : a new approach to emotional health and clear thinking (First ed.). Chalvington, East Sussex: HG Publishing. ISBN 978-1-899398-31-7. https://archive.org/details/humangivensnewap00grif. 
  3. ↑ 3.0 3.1 Use of the term 'organising idea' as a way of referring to human thinking/perceptual processes seems to have originated with Henri Bortoft and is much used in human givens literature. "What is an organising idea?". 20 October 2015. http://www.hgi.org.uk/organising.htm. 
  4. ↑ 4.0 4.1 "Press Release: 11 May 2016: Independent quality mark for Human Givens practitioners". Professional Standards Authority for Health and Social Care (PSA). 11 May 2016. https://www.professionalstandards.org.uk/docs/default-source/press-releases/psa-press-release---hgi-accreditation.pdf?sfvrsn=86d07120_0. Retrieved 3 March 2020. 
  5. ↑ "Dr. Abraham Maslow, Founder Of Humanistic Psychology, Dies". New York Times. June 10, 1970. https://www.nytimes.com/1970/06/10/archives/dr-abraham-maslow-founder-of-humanistic-psychology-dies.html. Retrieved 2010-09-26. "Dr. Abraham Maslow, professor of psychology at Brandeis University in Waltham, Mass., and founder of what has come to be known as humanistic psychology, died of a heart attack. He was 62 years old." 
  6. ↑ Seligman, Martin (2002). Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment. ISBN 9780743222983. https://archive.org/details/authentichappine00seli. 
  7. ↑ Seligman, Martin (2011). Flourish: A Visionary New Understanding of Happiness and Well-Being. ISBN 9781439190753. 
  8. ↑ See references for Chapter 5 of the new edition of the core human givens book: Griffin, Joe; Tyrrell, Ivan (2013). Human givens : The new approach to emotional health and clear thinking (New ed.). Chalvington, East Sussex: HG Publishing. pp. 97–153. ISBN 978-1899398317. http://www.humangivens.com/publications/human-givens-book.html. 
  9. ↑ Marmot, Michael; Ruth Bell. "WORK STRESS AND HEALTH: the Whitehall II study". Public and Commercial Services Union on behalf of Council of Civil Service Unions/Cabinet Office. http://www.ucl.ac.uk/whitehallII/pdf/Whitehallbooklet_1_.pdf. "We found that during the periods of insecurity in the run up to the privatisation, civil servants in PSA suffered more physical ill-health than their unaffected counterparts and they also experienced adverse changes in some of the well-known risk factors for heart disease, such as blood pressure." 
  10. ↑ Stansfeld, Stephen A.; Fuhrer, Rebecca; Head, Jenny; Ferrie, Jane; Shipley, Martin (July 1997). "Work and psychiatric disorder in the Whitehall II Study". Journal of Psychosomatic Research 43 (1): 73–81. doi:10.1016/S0022-3999(97)00001-9. PMID 9263933. 
  11. ↑ Stansfeld, S.A.; Fuhrer, R; Shipley, M.J.; Marmot, M.G. (1999). "Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study.". Occupational & Environmental Medicine 56 (5): 302–307. doi:10.1136/oem.56.5.302. PMID 10472303. "The associations between the three Karasek work characteristics, decision authority, skill discretion, job demands, and effort-reward imbalance predicting the combined risk of psychiatric disorder at phases 2 and 3, are reported in table 1. High efforts in combination with low rewards were strikingly associated with an increased risk of psychiatric disorder. This has not previously been reported.". 
  12. ↑ Wheeler, Mark. "UCLA researchers identify the molecular signature of loneliness". UCLA. http://newsroom.ucla.edu/releases/Loneliness-Is-a-Molecule-UCLA-8214?RelNum=8214. 
  13. ↑ Cole, Steve W. et al. (2007). "Social regulation of gene expression in human leukocytes". Genome Biology 8 (9): Article R189. doi:10.1186/gb-2007-8-9-r189. PMID 17854483. 
  14. ↑ "Solirary Watch - Journal Articles". http://solitarywatch.com/resources/journal-articles/. 
  15. ↑ Deci, Edward L.; Ryan, Richard M. (1985). Intrinsic Motivation and Self-Determination in Human Behavior. doi:10.1007/978-1-4899-2271-7. ISBN 9781489922731. 
  16. ↑ Bartholomew, K.J. et al. (November 2011). "Self-Determination Theory and Diminished Functioning: The Role of Interpersonal Control and Psychological Need Thwarting". Personality and Social Psychology Bulletin 37 (11): 1459–1473. doi:10.1177/0146167211413125. PMID 21700794. http://pure-oai.bham.ac.uk/ws/files/2922254/BartholomewNtoumanisPersonalitySocialPsyBull2011.pdf. "Within Self Determination Theory, the nutriments for healthy development and functioning are specified using the concept of basic psychological needs for autonomy, competence, and relatedness. To the extent that the needs are ongoingly satisfied people will develop and function effectively and experience wellness, but to the extent that they are thwarted, people more likely evidence ill-being and non-optimal functioning. The darker sides of human behavior and experience, such as certain types of psychopathology, prejudice, and aggression are understood in terms of reactions to basic needs having been thwarted, either developmentally or proximally.". 
  17. ↑ Maslow, Abraham (July 1943). "A theory of human motivation". Psychological Review 50 (4): 370–396. doi:10.1037/h0054346. "Thus it seems impossible as well as useless to make any list of fundamental physiological needs for they can come to almost any number one might wish, depending on the degree of specificity of description.". 
  18. ↑ Reis, Harry T. et al. (April 2000). "Daily Well-Being: The Role of Autonomy, Competence, and Relatedness". Personality and Social Psychology Bulletin 26 (4): 419–435. doi:10.1177/0146167200266002. "Subsequently, we have tested the importance and generality of these needs and have found that, across many eastern and western cultures, these needs are essential for psychological health in each country we have studied (e.g., Chirkov, Ryan, Kim, & Kaplan, 2003), and we were pleased to see the new evidence on this matter provided in Sheldon et al’s target article.". 
  19. ↑ Deci, Edward L. et al. (2001). "Need Satisfaction, Motivation, and Well-Being in the Work Organizations of a Former Eastern Bloc Country: A Cross-Cultural Study of Self-Determination". Personality and Social Psychology Bulletin 27 (8): 930–942. doi:10.1177/0146167201278002. 
  20. ↑ Ryan, Richard M.; Edward L. Deci (Jan 2000). "Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being". American Psychologist 55 (1): 68–78. doi:10.1037/0003-066X.55.1.68. PMID 11392867. "In conclusion, the present study provides evidence in support of the self-determination model of work motivation across two very different cultures and types of work organizations. More specifically, the results suggest that the study of basic psychological needs may be relevant across quite divergent cultures with different political, economic, and value systems.". 
  21. ↑ Deikman, Arthur J. (1982). The Observing Self: Mysticism and Psychotherapy (1 ed.). Beacon Press. ISBN 978-0807029510. https://archive.org/details/observingselfmys00deik. 
  22. ↑ Baars, Bernard J.; Ramsøy, Thomas Z.; Laureys, Steven (December 2003). "Brain, conscious experience and the observing self". Trends in Neurosciences 26 (12): 671–675. doi:10.1016/j.tins.2003.09.015. PMID 14624851. 
  23. ↑ LeDoux, Joseph (2003). The emotional brain : the mysterious underpinnings of emotional life ([Nachdr.] ed.). London: Phoenix. ISBN 978-0753806708. 
  24. ↑ Libet, B; Gleason, CA; Wright, EW; Pearl, DK (1983). "Time of conscious intention to act in relation to onset of cerebral activity (readiness-potential). The unconscious initiation of a freely voluntary act.". Brain : A Journal of Neurology 106 (3): 623–42. doi:10.1093/brain/106.3.623. PMID 6640273. 
  25. ↑ Hughes, edited by Rick; Cooper, Cary L.; Kinder, Andrew (2012). International handbook of workplace trauma support (1 ed.). Chichester, West Sussex: Wiley-Blackwell. pp. Chapter 9. ISBN 978-0-470-97413-1. 
  26. ↑ Griffin, Joe; Tyrrell, Ivan; Winn, Denise (2004). How to lift depression ( --fast) : a practical handbook. Chalvington: HG Pub.. ISBN 978-1-899398-41-6. 
  27. ↑ Griffin, Joe; Tyrrell, Ivan; Winn, Denise (2005). Freedom from addiction : the secret behind successful addiction busting : a practical handbook. Chalvington: HG Pub.. ISBN 978-1899398461. 
  28. ↑ "What is hypnosis?". http://blog.humangivens.com/2012/11/what-is-hypnosis.html. 
  29. ↑ "Caetextia Website". http://caetextia.com/. 
  30. ↑ "Ivan Tyrrell and Richard Bentall discuss patient-centred new approaches to the understanding and treatment of psychotic illness.". http://www.hgi.org.uk/archive/newlook-psychosis.htm. 
  31. ↑ Andrews, William; Twigg, Elspeth; Minami, Takuya; Johnson, Gina (Dec 2011). "Piloting a practice research network: A 12-month evaluation of the Human Givens approach in primary care at a general medical practice". Psychology and Psychotherapy: Theory, Research and Practice 84 (4): 389–405. doi:10.1111/j.2044-8341.2010.02004.x. PMID 22903882. 
  32. ↑ Yates, Yvonne; Atkinson, Cathy (2011). "Using Human Givens therapy to support the well‐being of adolescents: a case example". Pastoral Care in Education 29 (1): 35–50. doi:10.1080/02643944.2010.548395. 
  33. ↑ Tsaroucha, Anna; Kingston, Paul; Stewart, Tony; Walton, Ian; Corp, Nadia (2012). "Assessing the effectiveness of the "human givens" approach in treating depression: a quasi experimental study in primary care". Mental Health Review Journal 17 (2): 90–103. doi:10.1108/13619321211270416. http://eprints.staffs.ac.uk/5358/1/Human%20Givens%20paper_Final_after_proof.doc. 
  34. ↑ Tsaroucha, Anna; Kingston, Paul; Corp, Nadia; Stewart, Tony; Walton, Ian (2012). "The emotional needs audit (ENA): a report on its reliability and validity". Mental Health Review Journal 17 (2): 81–89. doi:10.1108/13619321211270407. http://eprints.staffs.ac.uk/496/1/ENA_MHR%20PROOF%20%281%29.pdf. 
  35. ↑ Swisher AK (2010). "Practice-based evidence.". Cardiopulm Phys Ther J 21 (2): 4. doi:10.1097/01823246-201021020-00001. PMID 20520757. 
  36. ↑ Peter Andrews, William; Peter Wislocki, Andrew; Short, Fay; Chow, Daryl; Minami, Takuya (23 September 2013). "A five-year evaluation of the Human Givens therapy using a practice research network". Mental Health Review Journal 18 (3): 165–176. doi:10.1108/MHRJ-04-2013-0011. 
  37. ↑ Adams, Shona. "EVALUATION OF HUMAN GIVENS 'REWIND TREATMENT' TO TREAT TRAUMA". http://pragmaticresearchnetwork.org.uk/poster_of_evaluation_sept_2013.pdf. 

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